Diabetes

Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina). It can cause blindness if left undiagnosed and untreated.

However, it usually takes several years for diabetic retinopathy to reach a stage where it could threaten your sight.
To minimise the risk of this happening, people with diabetes should:

  • Ensure they control their blood sugar levels, blood pressure and cholesterol
  • Attend diabetic eye screening appointments – annual screening is offered by the NHS to all people with diabetes aged 12 and over to pick up and treat any problems early on

How diabetes can affect the eyes

The retina is the light-sensitive layer of cells at the back of the eye that converts light into electrical signals.

The signals are sent to the brain and the brain turns them into the images you see.

The retina needs a constant supply of blood, which it receives through a network of tiny blood vessels. Over time, a persistently high blood sugar level can damage these blood vessels in three main stages:

  • Tiny bulges develop in the blood vessels, which may bleed slightly but don’t usually affect your vision – this is known as background retinopathy
  • More severe and widespread changes affect the blood vessels, including more significant bleeding into the eye – this is known as pre-proliferative retinopathy
  • Scar tissue and new blood vessels, which are weak and bleed easily, develop on the retina – this is known as proliferative retinopathy and it can result in some loss of vision

However, if a problem with your eyes is picked up early, lifestyle changes and/or treatment can stop it getting worse.

Am I at risk of diabetic retinopathy?

Anyone with type 1 diabetes or type 2 diabetes is potentially at risk of developing diabetic retinopathy.

You’re at a greater risk if you:

  • Have had diabetes for a long time
  • Have a persistently high blood sugar (blood glucose) level
  • Have high blood pressure
  • Have high cholesterol
  • Are pregnant
  • Are of Asian or Afro-Caribbean background

By keeping your blood sugar, blood pressure and cholesterol levels under control, you can reduce your chances of developing diabetic retinopathy.

Diabetic eye screening

Everyone with diabetes who is 12 years old or over is invited for eye screening by the NHS once a year. This is arranged through your local GP practice.

Screening is offered because:

  • Diabetic retinopathy doesn’t tend to cause any symptoms in the early stages
  • The condition can cause permanent blindness if not diagnosed and treated promptly
  • Screening can detect problems in your eyes before they start to affect your vision
  • If problems are caught early, treatment can help prevent or reduce vision loss

The screening test involves examining the back of the eyes and taking photographs. Depending on your result, you may be advised to return for another appointment a year later, attend more regular appointments, or discuss treatment options with a specialist.

Reduce your risk of diabetic retinopathy

You can reduce your risk of developing diabetic retinopathy, or help prevent it getting worse, by:

  • Controlling your blood sugar, blood pressure and cholesterol levels
  • Taking your diabetes medication as prescribed
  • Attending all your screening appointments
  • Getting medical advice quickly if you notice any changes to your vision
  • Maintaining a healthy weight, eating a healthy, balanced diet, exercising regularly and stopping smoking

Treatments for diabetic retinopathy

Treatment for diabetic retinopathy is only necessary if screening detects significant problems that mean your vision is at risk.

If the condition hasn’t reached this stage, the above advice on managing your diabetes is recommended.
The main treatments for more advanced diabetic retinopathy are:

    • Laser treatment
    • Injections of medication into your eyes
    • An operation to remove blood or scar tissue from your eyes

Eye examinations and Diabetics

As a diabetic you are entitled to have a free NHS sight test. It is really important to continue to have regular eye examinations even if you are attending for regular Diabetic Screening appointments. Remember the screening is only to look for signs of diabetic eye disease, it does not screen for other eye diseases.

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